Primary care and specialities

[DingDongD]

Hi there,

I am a bit confused about the definition of primary care. If I want to go into internal medicine and specialize in nephrology, am I going into primary care? Am I specializing?

Thank you, ahead!

---

Members don't see this ad.

 

[gyngyn]

Hi there,

I am a bit confused about the definition of primary care. If I want to go into internal medicine and specialize in allergy, am I going into primary care? Am I specializing?

Thank you, ahead!

Allergy is not primary care, nor are any of the IM sub-specialties. General Internal Medicine is primary care.

 

[Lawpy]

Hi there,

I am a bit confused about the definition of primary care. If I want to go into internal medicine and specialize in nephrology, am I going into primary care? Am I specializing?

Thank you, ahead!

Allergy is not primary care, nor are any of the IM sub-specialties. General Internal Medicine is primary care.

I'm not sure who had mentioned this, but primary care is an area of medicine that involves longitudinal relationships between the physician and patients. Basically, I like thinking primary care as the first (or "primary") line of healthcare delivery. So, primary care can be best categorized into: family medicine, general pediatrics, general internal medicine, and general OB/GYN.

Nephrology is an IM subspecialty, so it's not primary care.

 

[DingDongD]

Okay! Thank you. I thought internal medicine was primary care. I did not realize there is general internal medicine. So, that's where my confusion was. But, I understand it now. Thank you.

 

[gyngyn]

I'm not sure who had mentioned this, but primary care is an area of medicine that involves longitudinal relationships between the physician and patients. Basically, I like thinking primary care as the first (or "primary") line of healthcare delivery. So, primary care can be best categorized into: family medicine, general pediatrics, general internal medicine, and general OB/GYN.

Nephrology is an IM subspecialty, so it's not primary care.

Psych is considered primary care as well.
http://nhsc.hrsa.gov/downloads/postgraduatetrainingbulletin.pdf

 

[Crayola227]

Psych is considered primary care as well.
http://nhsc.hrsa.gov/downloads/postgraduatetrainingbulletin.pdf

really? they seem the oddest of the bunch to include
OTOH..... I just contradicted everything I believe in saying that!
If we want to include psych, than I also want to include dental.

I should just say that the rest of the primary care specialties listed are more similar in terms of problems addressed than psych. I have heard stories of the surgical specialties listed actually acting as THE PCP surprise me. Some surgeons and ob/gyns out there do the yearly preventative health screening they can do, USPTF recs, like for vaccines, managing hyperlididemia, hyptertension, DM, and almost all the referrals. Depends on the issues though. Some peds manage their peds patients to adulthood and death in some cases. You just have to have a good reason to justify it, keep it simple, and know when to refer.
OTOH, I don't see psych doing the above or dental. I do think they should be added to the list of providers that we think of as primary care.

Some want to include Emergency Medicine in the list for various reasons. I can understand the rationale but it really shouldn't be as far as it isn't a "longitudinal" relationship.

 

[gyngyn]

really? they seem the oddest of the bunch to include
OTOH..... I just contradicted everything I believe in saying that!
If we want to include psych, than I also want to include dental.

I should just say that the rest of the primary care specialties listed are more similar in terms of problems addressed than psych. I have heard stories of the surgical specialties listed actually acting as THE PCP surprise me. Some surgeons and ob/gyns out there do the yearly preventative health screening they can do, USPTF recs, like for vaccines, managing hyperlididemia, hyptertension, DM, and almost all the referrals. Depends on the issues though. Some peds manage their peds patients to adulthood and death in some cases. You just have to have a good reason to justify it, keep it simple, and know when to refer.
OTOH, I don't see psych doing the above or dental. I do think they should be added to the list of providers that we think of as primary care.

Some want to include Emergency Medicine in the list for various reasons. I can understand the rationale but it really shouldn't be as far as it isn't a "longitudinal" relationship.

Dentistry is a different profession. General dentistry is considered primary care by the NHSC.
EM is the antithesis of primary care.

 

[candbgirl]

My rheumatologist is my PCP and that's how he wants it. I'm glad too since it saves me from having to remember everything complex in my history. He always says I was an internist first.


Sent from my iPad using SDN mobile app

 

[Lawpy]

Some want to include Emergency Medicine in the list for various reasons. I can understand the rationale but it really shouldn't be as far as it isn't a "longitudinal" relationship.

EM is the opposite of primary care.

I can easily see a huge controversy brewing over in the EM Forums when we categorize them as primary care

 

[Crayola227]

I can easily see a huge controversy brewing over in the EM Forums when we categorize them as primary care

Sad thing is I can't say I came up with the joke - it was actually from people in EM that I think were simultaneously trying to laugh off their biggest work complaint while also trying to somehow cheer themselves up for doing it.

I've always gotten away with this joke in person, but I wouldn't be surprised if one day I said it and an EM doc stabbed me in the face.

It's more fair to say that EM can be lumped in with other fields as a "generalist" field. Most of the ones on the primary care list count as that as well.

good point
@candbgirl
I almost listed rheum for fun and didn't
there was a debate on another thread about IM subspecialists that sometimes act as general internists after fellowship
cards is another where I've seen it